Pharmacy claims are submitted with billing units in the “Unit of Measure” field (6ØØ-28):

  • Each (EA), used when the product is dispensed in discreet units
  • Gram (GM), used when a product is measured by its weight
  • Milliliter (ML), used when a product is measured by its liquid volume

Pharmacy staff should be aware of the correct billing units on certain medications to alleviate billing discrepancies, which can lead to potential audit risks. Quantity for milliliters and grams must be divisible by package size. Some products (such as Risperdal Consta, Humira, Enbrel, Lovenox, Neupogen, Pegasys, and Procrit) may have varying units depending on the NDC number.

Refer to the NCPDP B1 Transaction Payer Sheet for the acceptable unit of measure values on a single ingredient and multi-ingredient compound claim.